title: Small doses of arginine vasopressin in combination with norepinephrine "buy" time for definitive treatment for uncontrolled hemorrhagic shock in rats.
abstract: Implementation of fluid resuscitation and blood transfusion are greatly limited in prehospital or evacuation settings after severe trauma or war wounds. With uncontrolled hemorrhagic shock rats, we investigated if arginine vasopressin (AVP) in combination with norepinephrine (NE) is independent (or slightly dependent) of fluid resuscitation and can "buy" time for the subsequently definitive treatment of traumatic hemorrhagic shock in the present study. The results showed that AVP (0.4 U/kg) alone or with NE (3 μg/kg) with one-eighth and one-fourth volumes of total blood volume of lactated Ringer's infusion significantly increased and maintained the mean arterial pressure. Among all groups, 0.4 U/kg of AVP + NE (3 μg/kg) with one-eighth volume of lactated Ringer's infusion had the best effect: it significantly increased and maintained hemodynamics and prolonged the survival time. This early treatment strategy significantly improved the effects of subsequently definitive treatments (after bleeding controlled): it increased the subsequent survival, improved the hemodynamic parameters, improved the cardiac function, and increased the tissue blood flow and oxygen delivery. These results suggested that early application of small doses of AVP (0.4 U/kg) + NE before bleeding control can "buy" time for the definitive treatment of uncontrolled hemorrhagic shock, which may be an effective measure for the early treatment of traumatic hemorrhagic shock.
authors.affiliation: State Key Laboratory of Trauma, Burns and Combined Injury, the Second Department of Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China.
authors.forename: Liangming
authors.initials: L
authors.lastname: Liu
authors.forename: Kunlun
authors.initials: K
authors.lastname: Tian
authors.forename: Mingying
authors.initials: M
authors.lastname: Xue
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhu
authors.forename: Dan
authors.initials: D
authors.lastname: Lan
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Peng
authors.forename: Yue
authors.initials: Y
authors.lastname: Wu
authors.forename: Tao
authors.initials: T
authors.lastname: Li
mesh_terms: D000818:Animals; D001127:Arginine Vasopressin / Q000008:administration & dosage* / Q000627:therapeutic use; D002245:Carbon Dioxide / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical / Q000379:methods; D004359:Drug Therapy, Combination; D005440:Fluid Therapy / Q000379:methods; D006439:Hemodynamics / Q000187:drug effects; D009638:Norepinephrine / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D051381:Rats; D017207:Rats, Sprague-Dawley; D055502:Secondary Prevention / Q000379:methods; D012771:Shock, Hemorrhagic / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin; D002245:Carbon Dioxide; D010100:Oxygen; D009638:Norepinephrine